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Clinical and spyrometric follow-up from 4 to 9 years after lobectomy for congenital lung malformations in children

Andrea Farolfi, Alessandra Zenga, Chiara Bersanini, Giulia Cammi, Sara Costanzo, Giovanna Riccipetitoni, Gian Vincenzo Zuccotti
European Respiratory Journal 2016 48: PA3139; DOI: 10.1183/13993003.congress-2016.PA3139
Andrea Farolfi
1Pediatric Department, V.Buzzi Children's Hospital, University of Milan, Milan, Italy
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Alessandra Zenga
1Pediatric Department, V.Buzzi Children's Hospital, University of Milan, Milan, Italy
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Chiara Bersanini
1Pediatric Department, V.Buzzi Children's Hospital, University of Milan, Milan, Italy
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Giulia Cammi
1Pediatric Department, V.Buzzi Children's Hospital, University of Milan, Milan, Italy
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Sara Costanzo
2Pediatric Surgery Department, V.Buzzi Children's Hospital, Milan, Italy
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Giovanna Riccipetitoni
2Pediatric Surgery Department, V.Buzzi Children's Hospital, Milan, Italy
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Gian Vincenzo Zuccotti
1Pediatric Department, V.Buzzi Children's Hospital, University of Milan, Milan, Italy
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Abstract

Background: Asymptomatic Congenital Lung Malformations (CLM) are often electively resected on the assumption that lobectomy has low impact on respiratory health and function. A recent meta-analysis showed that elective resection is safe and prevents the risk of symptoms development, which may result in a higher rate of postoperative complications.

Aim of the study: To assess respiratory symptoms and lung function at school age in children who underwent lobectomy for asymptomatic CLM.

Materials and Methods: We retrospectively reviewed performance, symptoms (open interview) and spirometric values of FEV1, FVC, FEV1/FVC and FEF75-25 with comparison to z-scores (Stanojevic S. et al., Am J Crit Care Med 2008;177(3):253-60) of 18 patients between 4-9 years of age.

Results: Between 2000-2009, 18 patients (9 female, 9 male) underwent elective lobectomy (8 upper left, 3 lower left, 6 lower right, 1 middle lobe) in our hospital, 13 patients within the first year of life and 5 after. The pathologic diagnoses were: 6 congenital lobar emphysema, 2 pulmonary sequestration and 10 Congenital Pulmonary Airway Malformation (CPAM).

At follow-up observation at 4-9 years of age, 14 patients were symptoms free and their effort tolerance was comparable to peers; 3 patients had effort dyspnea and reduced effort tolerance, 1 had occasional wheeze controlled with inhaled corticosteroids therapy.

Mean and median of FEV1, FVC and FEV1/FVC were within normal range if compared to z-scores, while FEF75-25 was lower (mean 1%, median 3.2%).

Conclusions: The majority of our 18 patients were symptoms free, 4 had mild symptoms and limitations. Lung function was essentially within predicted values.

  • Congenital lesion/malformation
  • Lung function testing
  • Surgery
  • Copyright ©the authors 2016
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Clinical and spyrometric follow-up from 4 to 9 years after lobectomy for congenital lung malformations in children
Andrea Farolfi, Alessandra Zenga, Chiara Bersanini, Giulia Cammi, Sara Costanzo, Giovanna Riccipetitoni, Gian Vincenzo Zuccotti
European Respiratory Journal Sep 2016, 48 (suppl 60) PA3139; DOI: 10.1183/13993003.congress-2016.PA3139

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Clinical and spyrometric follow-up from 4 to 9 years after lobectomy for congenital lung malformations in children
Andrea Farolfi, Alessandra Zenga, Chiara Bersanini, Giulia Cammi, Sara Costanzo, Giovanna Riccipetitoni, Gian Vincenzo Zuccotti
European Respiratory Journal Sep 2016, 48 (suppl 60) PA3139; DOI: 10.1183/13993003.congress-2016.PA3139
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